Agenda item

Jon Hobday, Consultant in Public Health to present information on substance misuse. Report attached.

Jon Hobday, Consultant in Public Health provided an update on substance misuse in Bury.

Substance misuse is a huge public health issue both locally and nationally. Alcohol misuse is costing approximately £3.5 billion a year to the NHS and approximately £21 billion a year to the wider economy. There are approximately 660,000 people who are alcohol dependant nationally, which is approximately 1900 people in Bury.

One in eleven people, aged between 16 and 59, have misused illegal substances within the last 12 months which is approximately 11,000 people in Bury. Alcohol misuse alone is associated to around 60 or more health issues. Alcohol misuse is the biggest risk factor linked to early deaths and ill health in the 15-49 year old cohort. 

Substance misuse is associated with unemployment, deprivation and homelessness and linked heavily with family breakdown and criminal activity.

A recent Dame Carol Black review (phase 2) which was specifically focused on substance misuse, found that there was not enough being done nationally to address this as a public health issue and needed significant reform in 4 key areas:

·         Leadership

·         Funding

·         Commissioning

·         Rebuilding

The following inequalities for substance misuse were explained:

• Poor mental health is linked to substance misuse and vice versa
• Men are more likely to use illegal drugs
• Unemployment, poor working conditions and job insecurity
• Homelessness
• Social economic deprivation
• Family history of addiction

Statistical information for Bury was shared:

• Alcohol related mortality remained stable at approximately 42 per 100,000 people which is approximately 6/7 deaths per year in Bury. This figure is similar to England.
• Admission episodes for alcohol related conditions remained stable at 470 per 100,000 people, which is approximately 860 people per year in Bury. This figure is better than England.
• 78.8% of dependent drinkers are not in service, which is approximately 1500 people in Bury. It was stated that this figure is concerning as there is a significant number of people who are not accessing services for support. Although this figure was better than England.
• There has been a decreasing number of drug related deaths. There were 8 deaths in 2020 which is 8.8 per 100,000 people. This figure is worse than England but better than the North West, this figure has been decreasing since 2018.
• There has been a decrease in numbers in service (apart from opiate service users) which is a national challenge due to Covid-19, it was suggested that numbers in service is now starting to pick up again.

Jon Hobday outlined the work that Bury is doing to address substance misuse. The next steps for Bury are to complete the action plan, continue to review the data and levels of inequality.

• Councillor Simpson questioned if there is any statistical information, in terms of success rates, from those who are in treatment.

Jon Hobday agreed to provide the Board with a breakdown of the information on substance misuse. Public health colleagues attend quarterly performance meetings with the substance misuse provider. The figures are positive, and any glitches in the figures are questioned. The provider looks at the figures from a holistic perspective rather than looking at substance misuse as a sole measure, they look at factors such as family relationships and people’s housing situation.

• Councillor Simpson questioned what work is being done with families who have a history of substance misuse.

Jon Hobday explained that when it is a younger cohort and there has been history of substance misuse in the family, the Early Help Team work on a family-based approach which focuses on supporting the family to create the environment where substance misuse will not be repeated over generations.

• Councillor Simpson questioned if both men and women could access community-based support for substance misuse.

Jon Hobday explained that there has been a shift in a shared care model, as during the pandemic there was a struggle to deliver the programme through GP practices. There will be a model that will be piloted in Radcliffe, due to a higher proportion of substance misuse. Looking forward, the model will be used to shift away from a central venue to treat people within their local areas.

• Councillor Simpson asked if the figures around substance misuse have been underestimated due to the increase of mental health issues during the pandemic.

Jon Hobday explained that there are a number of users who are not in service. The referral model has been changed slightly. If someone is referred or self-referred and has a lower need, they are supported to self-care and access other resources in the community without coming into service. There is a link between mental health and substance misuse, data is being analysed to ensure that the mental health challenges that have been as a result of Covid-19 are being understood.

Lesley Jones advised that Health and Wellbeing Board members should be asking questions due to a significant number of people who are dependent on alcohol and misusing substances who are not being reached by services:

• What would the rest of our system, services and communities need to do, to support and motivate people to engage with services?
• Is there a wider role for the Health and Wellbeing Board in supporting that effort?

Councillor Simpson questioned if people with lived experience could carry out outreach work with their community.

Jon Hobday explained that there are programmes where people with lived experiences from communities are talking to others about alcohol misuse and giving quality assured advise, that they have had completed the training on. It was explained that a lot of work can be completed through the community and community hub to raise awareness.

It was agreed:

1.         That the Health and Wellbeing Board continues to support the ongoing work around drugs and alcohol and reducing inequalities.

2.         Jon Hobday to provide the Board with information on the treatment success rate.